Male Hypoactive Sexual Desire Disorder

Male Hypoactive Sexual Desire Disorder (MHSDD) is defined as the lack or inability to have normal sexual thoughts or desires in a consistent or recurrent manner for a long time. The symptoms must be present for at least 6 months and cause stress. The disorder is categorized on the basis of the severity of symptoms.


Data suggests that Male Hypoactive Sexual Desire Disorder is categorized as a generalized sexual disorder that is unrelated to specific gender; however, new research clearly demonstrates the significant differences between gender roles and their association. Some studies show that at least 15% of men are affected by this disorder. The association of complete lack of, or substantial decrease in sexual desire is generally considered to occur because of erectile dysfunction (ED) and other sexual disorders.   


The epidemiology of Male Hypoactive Sexual Desire Disorder:

Recent studies show there is a strong association with psychological distress and issues with men aged 16-44 with decreased sexual interest or erectile dysfunction by 15-17%. Older men typically go through bodily changes that impact desire or performance but that does not constitute a diagnosis of Male Hypoactive Sexual Desire Disorder because these changes may very well fall within what is considered normal limits. 

Symptoms of Male Hypoactive Sexual Desire Disorder:

  • Either delayed or decreased desire for sexual activities along with the inability to reach orgasm during sex.
  • Early ejaculation is usually within 1 minute after engaging in sexual activity and feeling dissatisfied.
  • Physical or psychological distress due to interpersonal conflicts with your partner or interactions with others.

Types of Male Hypoactive Sexual Desire Disorder

There are four subtypes: 

  1. General (general lack of sexual desire)
  2. Situational (loss of sexual interest with your partner at a given time)
  3. Acquired, which occurs normally due to prolonged periods of sexual relations
  4. Lifelong (i.e., a person may be asexual)

Possible causes of Male Hypoactive Sexual Desire Disorder

There are two major etiologies related to MHSDD: 

Biological causes:

  • Neurological involvement
  • Circulatory abnormalities
  • Hormonal imbalances like decreased levels of testosterone
  • Alcoholism
  • Smoking 
  • Illicit drug use

Psychosocial causes:

  • History of child abuse
  • Depression
  • Lack of relationships
  • Psychological disorders associated with decreased sexuality
  • Social anxiety
  • Physiological or systemic causes leading to lack of arousal
  • Overburden of work causing stress

 How is Male Hypoactive Sexual Desire Disorder diagnosed?

In order to make an exact and early diagnosis, the Diagnostic and Statistical Manual of Psychological Disorders-5 has made certain criteria necessary:

  • For minimum criteria, the person suffering from MHSDD should have 75% of decreased sexual arousal or desire for at least 6 months persistently.
  • A history of marked absence decreased level or continuous stimulation and reaching of orgasm during sexual interactions for a minimum period of 6 months or more.
  • History of clinically assessed distress persistently caused by the sexual disorder
  • The problem at hand does not correlate with other associated comorbidities or medicinal effects and should completely be ruled out by proper assessments.

What are the common risk factors associated with Male Hypoactive Sexual Desire Disorder?

  • Psychological: it is associated with the presence of depression or having anxiety
  •  Physiological: these include hormonal imbalances with decreased testosterone levels as seen in andropause 
  •  Behavioral abnormalities associated with biological disturbances: A person who drinks alcohol, smokes or uses illicit drugs that lead to neurological or vascular disturbances.
  • History of surgical Procedures: surgeries involving the prostate or spinal cord cause decreased sex drive.
  • Psychosocial Factors:

Past history of traumas from growing up in an abusive household. This trauma can be emotional, physical, or sexual in nature and does not permit healthy and trusting relationships during adulthood.  

Treatment options for Male Hypoactive Sexual Desire Disorder

  • Psychotherapy involves engaging with both partners and creating a better understanding of the disorder, how to work through it, and manage their sex life. 
  • Cognitive-behavioral therapy (CBTs): Includes making strategies for sexual arousal problems and resolving them by effective sexual stimulatory training for both partners by improving sexual skills. Solving the root cause is always a better management plan.
  • Hormonal replacement therapy or hormonal treatments. There are medications that can help to improve testosterone levels usually caused by andropause or hypogonadism. Testosterone therapy is the only scientifically evident hormonal replacement therapy for men and has proven to improve sexual drive.
  • Medication changes: If you take any prescription drugs speak to your doctor about how they may affect your sexual desire and performance. An example of this is medications that are prescribed for high blood pressure or depression. Your doctor will help find an alternative prescription medication. 
  • Antidepressant drugs if necessary to manage psychological distress that the disorder causes. The medication is prescribed for those who experience depression and/or anxiety caused by stress within their relationships or sexual behaviors.